Hekman and his colleagues evaluated 12,091 patient reports about 113 doctors working at a large HMO in the Pacific Northwest. They also studied objective data about the doctors. The regularity with which doctors place heart patients on certain drugs, for example, is a good measure of the quality of their care. The number of e-mails doctors send patients is a measure of their accessibility. And the number of questions doctors ask patients during checkups is a measure of their diligence.

In all these domains, however, Hekman found that these objective measures of performance correlated with patient satisfaction reports only when the doctors were white men. For women and minorities, extra quality, accessibility and diligence not only did not result in better evaluations by patients — they produced worse evaluations. …

In a related experiment involving bookshop employees, volunteers were shown two videotaped interactions between a customer and a sales clerk and were told to imagine they were customers and rate the shop’s service. Some were shown a white male sales clerk, while others were shown a black male clerk or a white female clerk. All the clerks were actors — and everything else in the videos was identical, down to the script.

Those shown the white male clerk rated the service provided 19 percent higher than volunteers shown the woman or the black man. They also rated stores with white male clerks as being cleaner. Hekman also studied the satisfaction levels of 3,600 golfers at 66 clubs nationwide. Clubs that employed higher numbers of Latinos were rated more poorly than clubs employing fewer minorities — even when they performed identically on objective measures.

People usually invoke two explanations for such behavior:

1) Irrational or ideological racism or sexism.

2) Rational stereotyping that just happens to go wrong in these cases.

But A third explanation seems to me more plausible:

3) We prefer to affiliate with higher status folks. If female doctors, black or female sales clerks, or latino golf club employees are considered lower status, then customers will be less satisfied with them even if they do exactly the same things.

Control for sex and gender and see if other status information causes similar effects?

Paul Gresham

I find the article quite ridiculous. It’s a shame the Washington Post call this science. For example who did they ask? Did they compare the results by asking people in China to watch a video of people doing business and see what they thought? Perhaps the connection is subliminal and connected to cultural similarities or shall we say ‘comfort’ level, which is totally subjective.

On average, people tend to the norm. It’s easy to slot into a stereotype and if lots of other people like you are doing the same, you can do so too without standing out and without being outstanding.

Perhaps our biases are well-founded? Perhaps we could infer from the information available that on average Latino workers in golf clubs are poor performers, or that on average female sales attendants are actually poorer performers? It may well be truly unfortunate that people who break away from the norm are not treated equally and this may well be something we could learn and benefit from. However the article sought to make an unscientific observation based upon a perceived effect with no regard to the cause. Utter poppycock.

You’re missing “Clubs that employed higher numbers of Latinos were rated more poorly than clubs employing fewer minorities — even when they performed identically on objective measures,” not to mention implicitly inflating the claims of the research.

Well, they really aren’t… but the irrationality can be on a group level instead of an individual level. “Does this person have high status?” is a question roughly equivalent to “Do other people think this person has high status?” If you think “other people” assign [people with characteristic X] low status, then, well, they are low status, even if you think that they shouldn’t be. And then, as far as everyone else is concerned, your assessment of low status becomes another data point which confirms that, indeed, [people with characteristic X] have low status.

Everyone can agree that [characteristic X] shouldn’t be a cause of low status, but still end up making it one and being unable to change it.

Taimyoboi

What about built in expectations regarding the effects of affirmative action?

Doug S.

Although the study in question has been accepted for publication, it has not yet been published. I did, however, manage to track down a copy from the personal home page of the main author. His page has a (rather informative) press release and a PDF of the actual paper.

Hal Finney

From the press release link posted by Doug above: “It is worth noting that customers were equally biased regardless of whether the minority employees were predominantly Asian (doctor study), African-American (bookstore study), or Latino (golf club study).” This argues against the status interpretation, because it seems to me that different minorities have different relative status within American society. Roughly speaking, I’d say Asians > Latinos > African-Americans. So the status interpretation would predict different levels of bias for the three races. However, the racism interpretation would probably predict the same thing.

http://hanson.gmu.edu Robin Hanson

What suggests that racists consider races to be more equal than status-conscious folks consider the status of those races to be?

Constant

Given that an African-American is the President of the United States and that the decision appears largely to have been a reaction to his perceived status rather than a comprehension of his advocated policies, and given that the rejection of Sarah Palin appears largely to have been a problem with her social status, we may want to review the assumption that “African Americans” are low status and “whites” are high status.

http://www.mccaughan.org.uk/g/ g

I don’t find your analysis of Obama’s success and Palin’s failure perfectly convincing; it seems to me that there are other (more obvious) possible causes that can’t be ruled out in each case.

Constant

g – I am not making an assertion about what was the primary cause, but about what was a factor. And even if it was no factor at all, do you dispute my claim that Palin is in the eyes of many low status, and Obama high? Do you dispute the related claim that one’s accent affects one’s perceived status? Do you dispute the related claim that one’s educational background affects one’s status by means which only partly relate to the education one received (e.g. do you dispute that who you know has a great effect on your prospects and that Harvard and Yale are a great way to know the right people)? Do you dispute that a great part of the effectiveness of a speech is not the content but the style (not just accent but other markers of status)? Do you dispute that many look upon certain kinds of Christians with contempt, this assigning them low status? Do you deny that certain interests, hobbies, and manners of dress are considered higher or lower status, and that Palin exhibits many low status markers? Do you deny that one can get the news pretty much anywhere (check out Google News to observe the massive redundancy) and that the point of asking what papers a person reads is probably in large part to obtain additional status markers? Do you deny that terms such as “redneck”, “trailer park trash”, “flyover country”, relegate the people and areas so labeled to low status? That last point is not specifically about Palin but is to illustrate the larger point that it is not so simple as white=high, black=low.

http://www.mccaughan.org.uk/g/ g

You said “appears largely to have been” rather than, say, “appears to have been in part”; I think it’s understandable that I interpreted that as a statement about the primary cause. I have no idea why you’re asking whether I “dispute” and/or “deny” a number of entirely different claims, most of which FWIW I agree with. It seems as if you are responding to someone entirely other than me making comments entirely different from mine.

Constant

g – If I had meant primary I would have said primary, not “largely”. However, I would like to add that there’s a lot of rationalization in choice, and that many of the supposedly substantial reasons for rejecting Palin are rationalizations thinly disguising a visceral reaction to her rusticity. An individual can well be the last person to know why he really makes the choices he does. Introspection is overrated.

tg

What is racism but presuming an individual’s status (high or low) because of race? Conclusion (3) is merely a more general stating of conclusion (1). Conclusion (1) identifies the likely cause of the presumed status of (3).

http://www.mccaughan.org.uk/g/ g

The thing that interests me here isn’t the difference in what standard of care people thought they were getting from high-status versus low-status doctors (if indeed status is they key thing here) but the difference in how much their assessment was affected by real differences in quality.

Why should the perceived quality of care from low-status (or out-group, or possibly-benefiting-from-affirmative-action, or poorer, or whatever) doctors vary *inversely* with the actual quality of care?

Spencer Greenwood

This got me thinking about politics. Does any of this cause you to worry about democracy? If people continue to prefer to affiliate with the most prestigious figure they’re presented with (or, if you’re averse to the assumption at the end of this article, if people simply prefer to affiliate with white males), then doesn’t this potentially say something very negative about voting habits?

Doug S, thanks for the link to the paper it is certainly very thorough.

Clearly a bias exists in American people that is now correlated (thanks to the report) to significant returns for Fortune 500 companies. The report makes a brash statement that this is unacceptable.

The implication is that if a large chain store were to sack all their low-status employees (btw, I simply despise that term used in the report) and employ white guys, then the companies revenues would increase. Surely then, the successful stores across America must be full of white guys? I have no empirical evidence to know if that is true or not. It would seem from the report that the only reason these stores have low-status (Agh) employees is because of legal or moral reasons, not because it makes good business sense!

It does cite a paper that bias’s may exist because they reflect a truth. However the report says nothing about how the discovered bias may correlate with some measure of overall quality that is perceivable. Let’s face it, even the report broadly classifies Latino’s, women and African American’s as low-status.

Training people to be more objective when taking such a survey would not suddenly improve the education system for low-status (Agh) individuals. In fact it would simply be another cover up of underlying bias’s.

I can’t see that this report does anything to help the situation as any savvy business person reading this will simply believe that perception is reality, rewarding staff accordingly, until perception changes.

Is this not trying to wag the dog by the tail?

John

It might be a response bias; people may only claim to have liked the white males better when confronted by an authority figure because they associate whites with authority and do not want to agitate them.

Hal Finney

What do you think would happen if the study subjects were themselves minorities? I would expect that members of minority groups would not be racially biased against their own group. However they may share a perception that white males are higher status then members of their group. This might allow distinguishing the two explanations.

Constant

I would expect that members of minority groups would not be racially biased against their own group.

However, two other possibilities:

1) They may rationally discriminate against their own race (that was explanation 2 in Robin’s post)

2) Status may not be a single scale for all, but may depend on your subgroup. I recall a while ago this idea, or something like it, was popular on the economics blogs. So a black person who prefers black businesses may be applying his own sense that blacks are higher status than whites.

http://mindtumor.blogspot.com JoshT

If Rush Limbaugh, or Sean Hannity sat next to me at a restaurant I think I would not only have a lower opinion of my food, but also feel that I would need to reevaluate my food choices. Not sure if they would count as celebrities anyway.

Jim Babcock

I find the use of prescription rate, e-mail rate, and number of questions asked as proxies for quality of care to be quite suspicious. Writing more prescriptions suggests writing some that’re unnecessary; sending more e-mails implies leaving questions unaddressed at the office; and asking more questions correlates with having a light case load. While it is interesting that these metrics correlate with perceived performance for some races and genders but not for others, I see no reason to treat positive correlation as correct and negative correlation as biased, and I see very strong reason to suspect that patients were actually judging performance based on something else entirely.

ThomasL

With the caveat I haven’t read the full paper, some of the most interesting points to me are:

The regularity with which doctors place heart patients on certain drugs, for example, is a good measure of the quality of their care.

Really? I mean, is that enough to know? Bad, lazy doctors don’t write prescriptions for their patients but good, diligent doctors do? I haven’t direct evidence, but I’d imagine a few things:

Most heart doctors place most heart patients on similar drug regimens. That is, I imagine this distribution is unusually tight.
Where there are outliers in the drug regimens, it may well be related to demographics, not quality. Perhaps subtle differences in population age, culture, or race can alter which drugs and treatments are considered most effective. (Wandering from the main point, but that cuts both to the patients, who by age or race maybe more receptive to certain treatments, and to the doctors. Eg, what if the minority doctors tended to be younger than the white, male doctors. They may have different training which leads them to prescribe more or fewer drugs. Age might also play a factor in patient satisfaction. I think most people instinctively feel more comfortable with a sixty-something, grey-haired doctor than a late twenties one, regardless of race or sex.)

Prescribing a drug may be as likely to indicate laziness as it is diligence. “Here, just take these twice a day…”

Hekman also studied the satisfaction levels of 3,600 golfers at 66 clubs nationwide. Clubs that employed higher numbers of Latinos were rated more poorly than clubs employing fewer minorities — even when they performed identically on objective measures.

I think there is another explanation for this. I think it is about perception in the club’s focus on quality. For example, if you are buying cutlery and you look at one set which looks nice, seems well made and has a mark, “Made in Germany.” And then you look at another which looks just as nice, just as well made, but says “Made in China.” Which one gives one a better feeling? My answer is Germany. But is that racist? Does that mean I like Germans better than I like Chinese? Not really. I perceive the “Made in China” stamp as a cost-cutting measure and the “Made in Germany” stamp as a premium. I think, “They outsourced production to China to get a better deal on manufacturing.” I actually want everyone to get a good deal on manufacturing, but it still reveals to me that the company was more concerned with cost than with “premiumness” (to coin a phrase). And that introduces the question, “If they are cutting costs there, where else might they be cutting?”

Hiring Latino workers is likewise often seen as a cost-cutting measure, reminding patrons, “If they are cutting cost there…”

It isn’t that other companies don’t cut costs, it is that they may do it without reminding that patron that they are.

I don’t think the perception that outsourcing production to China or hiring Latino workers is cost-cutting is either mistaken or comments one way or the other on racism, as cost is, in fact, why most businesses that choose to do so do it.